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Human-centred design: integration of health and safety

A human-centred design approach to work provides a framework for compassionate, targeted, integrated, grass-roots leadership. It is an effective practice to involve workers in proactive, predictive design of safe and productive work.1 – 4 The approach recognises that there is variability associated with everyday performance. Rather than trying to control performance, efforts are made to understand, target design, and support performance variability.3 – 6 Human- centred design represents well-integrated business systems since it requires top-tier leadership commitment, budget support, and collaboration among operations, maintenance, procurement, assets management, engineering design, workforce strategy, safety and health teams.7

Human-centred design provides a critical link of safety with health and wellness initiatives.8 As health and wellness research proliferates, a compelling body of evidence begs safety professionals to transfer what once might have seemed like a nicety into the realm of necessity with the application of serious risk management practice. A business must mitigate foreseeable risk. It is in this context that safety and health become coupled. For example, in quarries, if we know that sitting all day is problematic to one’s health9, we must ask what is being done in workplace design to enable operators more opportunity for regular intervals of movement and postural variation? If we know that psychological distress is of grave concern10 yet we also know that participatory ergonomics and human-centred design can improve lead indicators for a positive safety climate, engage workers and develop positive attitudes at work3, 11, then what reliable, sustainable efforts are being employed to ensure that these practices are embedded at all levels of operation, workforce strategy, and work design?

Risk registers can be used to weave public health findings into various aspects of workplaces as this will foster accountable work practices. This stimulates communication of hazards, risk determination, control intervention, and assessment of controls. In turn, contextualised lead indicators may be mapped out and communicated with transparency in order to elevate a business from compliance at a bare minimum level of performance to one that is predictive to achieve positive outcomes and optimum productivity. There is little value in adopting a 30+ year-old business position as “employer of choice” if progressive, evidence- based lead indicators for success are not a target of performance. 

Further, the best practice guidelines to implement workplace wellness sing in harmony with recommendations to adopt effective human-centred design – senior leadership to provide active support and participation; provision of a supportive environment; active stakeholder involvement; participatory planning and design; targeted, customised and contextualised interventions to address critical needs; evaluation, measurement, monitoring and communication.12 Human-centred design, participatory ergonomics, and risk management resources for industry are emerging. Examples include:
• Human Factors Integration guidance documents in the transport industry.13
• Design for Operability and Maintainability Analysis Technique (Design-OMAT) and Earth Moving Equipment Design Evaluation for Equipment Procurement (EDEEP).14
• RiskGate: risk control information for priority unwanted events in coal mining.15
• International Council on Mining and Metals (ICMM) Health and Safety Critical Control Management Good Practice Guide.16
• Whole Body Vibration smart phone application for spontaneous quick on- site screening, management plans and literature resources.17
• ErgoAnalyst: risk management software solution to effectively identify acute and cumulative musculoskeletal disorders and involve workers in development and evaluation of critical controls.18, 19
• FMV: FRAM (Functional Resonance Analysis Method) Model Visualiser: free software that provides graphic illustration of functions within organisational systems required to accommodate resonance that arises from the variability of everyday performance.20

Lead indicators for quality performance are often grouped into three areas with examples in Table 1.



It may be accepted generally that business needs integrated work, safety, health and wellness programs. However, it remains a challenge to identify those programs that would pass the litmus test of quality and effectiveness.

Services are often selected that promote comfortable, staid processes consistent with “industry standard”. However, they may be practices that are also low in effect. These practices enable business to “keep getting what they got as they keep doing what they do”, yet at least the business feels that they are doing something. The next challenge is to evolve this line of thinking and work practice and manage change for the better.

This phenomena may be understood in an inverse triangle representing a tiered range of activity that we have referred to as KS-KU-UU, or “Known-Spoken, Known-Unspoken, and Unknown-Unspoken”.21 The “KS” (Known-Spoken) element reflects common vernacular and a collective idea, generally, of the way things ought to be done. This may represent practices that are widespread as they have been in existence over the last 30 years in business operations. While some of the practices may be determined ineffective through systematic review of primary research (Cochrane studies), they remain pervasive simply by the element of familiarity: they are widely known. The practices reflect homogeneity in industry work culture and there is low chance of divergent thinking or perceived risk-taking in their adoption.

For example, manual handling training, a practice to teach workers how to improve their lift and bend approach and prevent back pain, is widely pursued as an option for training delivery in manual labour industries. It is a service that is easily accessible, delivered by numerous providers with varying credentials, and cost is typically competitively low in terms of upfront initial investment. However, the desired effect of preventing back pain is without evidence.22, 23 Short- term investment is relatively low but, long- term, it is costly to do anything in business that consumes resources and does nothing to achieve desired results.

{{image6-a:l-w:640}}{{image4-a:r-w:200}}The KU element (Known-Unspoken) represents emerging knowledge that may have a rich and growing history of evidence among experts in the field or an inner circle of researchers and specialised practitioners in select industries. The information may not be pervasive or common cross-industry among varied disciplines and laypersons. While practices are somewhat known, and well supported by evidence-based research, they may be unspoken in organisations as they may represent issues that seem too big or complex with which to grapple. Organisations may not really want to dig too deep for fear of what may be discovered: solutions and strategies require changes to a system or capital investment, and the accountability for such outcomes is deemed easy to defer. The investigation or work practice at this level may reveal vulnerabilities in an organisation, work system, or leadership practice. Leadership must be involved in effective work strategy at this level and thus a project may require consensus, team building and management. Initial investment or commitment may be low to moderate, and access to providers may be more limited than at the KS level, but quality may be high. Examples in this realm may include participatory ergonomics with critical control intervention, human-centred design for capital works or equipment, investigation of whole-body vibration or occupational hygiene interventions.

{{image5-a:r-w:250}}However, this KU area is one to which industry ought to pay attention. It is the opinion of the authors that not all opportunities need be tackled with immediacy – in fact, it would likely be overwhelming if a business were to embrace everything deemed as “best practice” all at once. However, similar to the line of thought in functional resonance and systems thinking, positive changes to a few things in a complex system, managed well, may result in a resounding positive effect that may not always be predicted.5, 6 In this vein, a highly potent activity, such as participatory ergonomics with critical control intervention, which is shown to reduce exposure risk to hazardous manual tasks, to engage workers, and to provide significant return on investment, may be readily adopted by an organisation and improve work morale.2 – 4


UU is the element of Unknown-Unspoken and this represents highly complex deep-dive investigations or systemic analysis of complex work activity. Evidence may be emerging with new discoveries among an elite field of researchers, and the services may be expensive with low access to providers. The work or investment may be high risk and not readily defensible yet and likely to be akin to a marketing “star” – a product based on a hunch or inclination, a window of opportunity, and the return may be significant with great reward but this is unknown. Examples may include no-blame incident investigations where actions are viewed as no-fault and motivators are deemed to be “right” at any given time from the perspective of each contributing element, including the human element.

In this regard, the performance of health, safety and environment managers, or other business leaders, could be reviewed without the quantitative scores based on key performance indicators, especially lag indicators, but rather with qualitative coaching, situational leadership, and motivational interviewing, moving towards an understanding of neuroscience to support high performance.


Both Figure 1 and Table 2 feature examples of KS-KU-UU practices as they relate to safety, health, and wellness.


A quick, ten-step guideline is provided to help businesses consider safety, health, and wellness program proposals.


A human-centred design approach to work provides a framework for leadership that is responsive to variability in a complex system and supports safety, health, and wellness of workers. This approach speaks to the design of work for health. An outline of practice activity has been proposed: KS-KU- UU – Known Spoken, Known Unspoken, and Unknown Unspoken – to stir discussion and stimulate review of valid program offerings. A quick 10-step program review checklist has been provided to help industry evaluate proposals.

Sara Pazell is the occupational adviser for human factors and ergonomics at Viva Health at Work, Queensland. Robin Burgess-Limerick is the professor of human factors at the Minerals Industry Safety and Health Centre.

This is part two of a concept related to the “Design of Work for Health” presentation by Sara Pazell at the 13th Annual Quarrying Safety & Health Seminar, Institute of Quarrying Australia, Brisbane, QLD, 10 June 2015.


1. Torma-Krajewski J, Steiner LJ, Burgess- Limerick R. Ergonomics Processes: Implementation Guide and Tools for
the Mining Industry. Pittsburgh, PA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH), 2009. Publication No. 2009- 107, Information Circular 9509. http://

2. Pazell S, Burgess-Limerick R, HorberryT, Davidson P. User-centred design for civil construction: Optimising productivity by reducing safety and health risks associated with the operation and maintenance of on-road vehicles and mobile plant. 19th Triennial Congress Proceedings of the International Ergonomics Association 2015. Accepted for publication 5 June, 2015.

3. Burgess-Limerick, R. Ergonomics for Manual Tasks. In CCH Australia Ltd., Australian Master OHS and Environment Guide; pp. 261 – 278. McPherson’s Printing Group. 2011.

4. Pazell S, Burgess-Limerick R, Horberry T, McGuire R. Human-centred design for road construction: Optimising productivity by reducing safety and health risks. Submitted for peer review to Australian Asphalt and Pavement Association International Flexible Pavements Conference Gold Coast 2015.

5. Hollnagel E. Coping with complexity: past, present and future. Cognition, Technology, and Work 2012; 14: 199 – 205.

6. Hollnagel E. Human factors/ ergonomics as a systems discipline? “The human use of human beings” revisited. Applied Ergonomics 2014, 45: 40 – 44.

7. Dul J, Neumann PW. Ergonomics contributions to company strategies. Applied Ergonomics 2009; 40: 745 – 752.

8. Pazell S, Burgess-Limerick R. Design of work for health: A human-centred design perspective. Quarry 23 (10), October 2015: 74-76.

9. Buckley JP, Hedge A, Yates T, et al. The sedentary office: A growing
case for change towards better health and productivity. Expert statement commissioned by Public Health England and the Active Working Community Interest Company. British Journal Sports Medicine 2015; 0: 1 – 6.

10. Newswire, Mates in Construction, uicide prevention program for construction industry. In: Quarry, 10 August 2012.

11. Lallemand C. Contributions of Participatory Ergonomics to the Improvement of Safety Culture in an Industrial Context. Work 2012; 41: 3284 – 3290.

12. Workplace Health Association Australia. Best Practice Guidelines. file:///C:/Users/Sara/Downloads/WHAA_ Best_Practice_Guidelines.pdf

13. Assets Standards Authority NSW Transport. TM U HF 00001 GU Guide to Human Factors Integration & TM U HF 00001 ST Human Factors Integration General Requirements.

14. Earth Moving Equipment Safety Roundtable: EDEEP and Design OMAT.

15. RiskGate:

16. ICMM International Council on Mining and Metals Health and Safety Critical Control Management Good Practice Guide.

17. Whole Body Vibration Management. WBVpod/Index.html

18. FAQ PErforM and ErgoAnalyst PErforM.pdf

19. Ergo Enterprises 2011. Introduction to ErgoAnalyst. download/introea.pdf

20. FMV: FRAM (Functional Resonance Analysis Method) Model Visualiser:

21. Darren Hill verified by email correspondence with Jac Edser. KS-KU-UU terms coined in conversation and based upon Prochaska’s theoretical model of change, from pre-contemplation through to action, maintenance, and potential relapse. 27 July 2015

22. Verbeek J, Martimo KP, Karppinen J. Manual material handling advice
and assistive devices for preventing and treating back pain in workers: a Cochrane Systematic Review. Journal of Occupational Environmental Medicine 2012: 69; 1, 79 – 80.

23. Martimo KP, Verbeek, J, Karppinen J, Furlan A. D., Takala, EP., Kuijer, PPFM, Jauhiainen M, Viikari-Juntura E. Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review. British Medical Journal, Feb 2008; 336, 7641: 429 – 431.

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